Case 174119

Referral category

Region of interest

Referral reason

Canaray 174119

Impacted tooth 31: Buccally positioned at the mandibular midline

Tooth 31 is vertically impacted. The crown of the tooth is positioned at the mandibular midline, mesiobuccal to the crowns of the impacted teeth 32 and 42 and buccal to the crown of the impacted tooth 41. No resorption is present on any of the adjacent permanent teeth. The residual follicle surrounding the crown appears normal and continuous with the follicles around the impacted teeth 32, 33, 41, 42, and 43. Root formation appears complete. The root apex is positioned at the inferior mandibular border and a prominent apical curve is present. The periodontal ligament space is visualized around the root circumference of the tooth, which suggests the absence of ankylosis. The crown of tooth 31 can be surgically accessed from the buccal aspect of the mandibular alveolar process, at the midline.

Axial views of tooth 31

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space around the root of tooth 31. No signs of ankylosis or resorption are present. The residual follicle surrounding the crown of the tooth appears normal and continuous with the follicles around the impacted mandibular anterior teeth.

Impacted tooth 32

The crown of the mesioangularly impacted tooth 32 is positioned distolingual to the crown of the impacted tooth 31, at the mesiobuccal surface of the crown of the impacted tooth 41, and mesiobuccal and slightly apical to the crown of the impacted tooth 33. No resorption is evident on any of the adjacent permanent teeth. The residual follicle surrounding the crown appears normal and continuous with the follicles around the impacted teeth 31, 33, 41, 42, and 43. The buccal surface of tooth 32 is mesially rotated by approximately 45 degrees. Root formation appears almost complete and the root apex is positioned at the inferior mandibular border. The periodontal ligament space is visualized around the root circumference of the tooth, which suggests the absence of ankylosis. The crown of tooth 32 can be surgically accessed from the buccal aspect of the mandibular alveolar process, distal to the crown of tooth 31 and mesial to the crown of tooth 33.

Axial views of tooth 32

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space around the root of tooth 32. No signs of ankylosis or resorption are present. The residual follicle surrounding the crown of the tooth appears normal and continuous with the follicles around the impacted mandibular anterior teeth.

Mesioangularly impacted tooth 33

The crown of the mesioangularly impacted tooth 33 is positioned distolingual and slightly occlusal to the crown of the impacted tooth 32. No resorption is evident on any of the adjacent permanent teeth. The residual follicle surrounding the crown appears normal and continuous with the follicles around the impacted teeth 31, 32, 41, 42, and 43. The buccal surface of tooth 33 is distally rotated by approximately 75 degrees and root formation is 75% complete. The periodontal ligament space is visualized around the root circumference of the tooth, which suggests the absence of ankylosis. The crown of tooth 33 can be surgically accessed from the lingual aspect of the mandibular alveolar process, distolingual to the crown of tooth 32.

Axial views of tooth 33

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space around the root of tooth 33. No signs of ankylosis or resorption are present. The residual follicle surrounding the crown of the tooth appears normal and continuous with the follicles around the impacted mandibular anterior teeth.

Unaffected tooth 34

The unerupted tooth 34 is vertically oriented. The follicle surrounding the crown of the tooth appears normal and root formation is progressing normally. Moderate physiologic resorption is present on the overlying tooth 74. No abnormalities are present in this region. The impacted tooth 33 has not had any effect on tooth 34. The apical third of the root of tooth 33 is positioned mesial to the developing root apex of tooth 34. No resorption is present at tooth 34.

Moderate physiologic resorption of tooth 73

Tooth 73 exhibits moderate physiologic root resorption in the region adjacent to the crown of tooth 33. Tooth 73 may require extraction in order to facilitate the eruption and orthodontic repositioning of tooth 33.

Impacted tooth 41: Lingually positioned at the mandibular midline

Tooth 41 is vertically impacted. The crown of the tooth is positioned at the mandibular midline, mesiolingual to the crowns of the impacted teeth 32 and 42 and lingual to the crown of the impacted tooth 31. No resorption is present on any of the adjacent permanent teeth. The residual follicle surrounding the crown appears normal and continuous with the follicles around the impacted teeth 31, 32, 33, 42, and 43. The buccal surface of tooth 41 is mesially rotated by approximately 20 degrees and root formation appears complete. The apical third of the root is positioned at the inferior mandibular border and an apical dilaceration is evident. The periodontal ligament space is visualized around the root circumference of the tooth, which suggests the absence of ankylosis. The crown of tooth 41 can be surgically accessed from the lingual aspect of the mandibular alveolar process, at the midline.

Axial views of tooth 41

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space around the root of tooth 41. No signs of ankylosis or resorption are present. The residual follicle surrounding the crown of the tooth appears normal and continuous with the follicles around the impacted mandibular anterior teeth.

Impacted tooth 42

The crown of the mesioangularly impacted tooth 42 is positioned at the mesiolingual surface of the crown of the impacted tooth 31, at the distobuccal surface of the crown of the impacted tooth 41, and mesiobuccal and slightly apical to the crown of the impacted tooth 43. No resorption is evident on any of the adjacent permanent teeth. The residual follicle surrounding the crown appears normal and continuous with the follicles around the impacted teeth 31, 32, 33, 41, and 43. The buccal surface of tooth 42 is mesially rotated by approximately 45 degrees. Root formation appears almost complete and the root apex is positioned at the inferior mandibular border. The periodontal ligament space is visualized around the root circumference of the tooth, which suggests the absence of ankylosis. The crown of tooth 42 can be surgically accessed from the buccal aspect of the mandibular alveolar process, at the distobuccal surface of the crown of tooth 41 and mesial to the crown of tooth 43.

Axial views of tooth 42

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space around the root of tooth 42. No signs of ankylosis or resorption are present. The residual follicle surrounding the crown of the tooth appears normal and continuous with the follicles around the impacted mandibular anterior teeth.

Mesioangularly impacted tooth 43

The crown of the mesioangularly impacted tooth 43 is positioned distolingual and slightly occlusal to the crown of the impacted tooth 42 and distal and slightly occlusal to the crown of the impacted tooth 41. No resorption is evident on any of the adjacent permanent teeth. The residual follicle surrounding the crown appears normal and continuous with the follicles around the impacted teeth 31, 32, 33, 41, and 42. The buccal surface of tooth 43 is distally rotated by approximately 75 degrees and root formation is 75% complete. The periodontal ligament space is visualized around the root circumference of the tooth, which suggests the absence of ankylosis. The crown of tooth 43 can be surgically accessed from the lingual aspect of the mandibular alveolar process, distal to the crown of tooth 41.

Axial views of tooth 43

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space around the root of tooth 43. No signs of ankylosis or resorption are present. The residual follicle surrounding the crown of the tooth appears normal and continuous with the follicles around the impacted mandibular anterior teeth.

Unaffected tooth 44

The unerupted tooth 44 is vertically oriented. The follicle surrounding the crown of the tooth appears normal and root formation is progressing normally. Moderate physiologic resorption is present on the overlying tooth 84. No abnormalities are present in this region. The impacted tooth 43 has not had any effect on tooth 44. The apical third of the root of tooth 43 is positioned mesial to the developing root apex of tooth 44. No resorption is present at tooth 44.

Moderate physiologic resorption of tooth 83

Tooth 83 exhibits moderate physiologic root resorption in the region adjacent to the crown of tooth 43. Tooth 83 may require extraction in order to facilitate the eruption and orthodontic repositioning of tooth 43.

Axial views of the anterior mandible

These axial cross-sectional images demonstrate the positioning of the impacted teeth 31, 32, 33, 41, 42, and 43. Tooth 31 is buccally positioned at the mandibular midline. Tooth 41 is lingually positioned at the mandibular midline. There is no evidence of root resorption on any of the adjacent permanent teeth. Teeth 32, 33, 41, 42, and 43 are rotated about their long axes.